Tocilizumab for Severe Worsening COVID-19 Pneumonia: a Propensity Score Analysis.

ABSTRACT: BACKGROUND:High levels of serum interleukin-6 (IL-6) correlate with disease severity in COVID-19. We hypothesized that tocilizumab (a recombinant humanized anti-IL-6 receptor) could improve outcomes in selected patients with severe worsening COVID-19 pneumonia and high inflammatory parameters. METHODS:The TOCICOVID study included a prospective cohort of patients aged 16-80 years with severe (requiring >?6 L/min of oxygen therapy to obtain Sp02?>?94%) rapidly deteriorating (increase by ??3 L/min of oxygen flow within the previous 12 h) COVID-19 pneumonia with ??5 days of symptoms and C-reactive protein levels >?40 mg/L. They entered a compassionate use program of treatment with intravenous tocilizumab (8 mg/kg with a maximum of 800 mg per infusion; and if needed a second infusion 24 to 72 h later). A control group was retrospectively selected with the same inclusion criteria. Outcomes were assessed at D28 using inverse probability of treatment weighted (IPTW) methodology. RESULTS:Among the 96 patients included (81% male, mean (SD) age: 60 (12.5) years), underlying conditions, baseline disease severity, and concomitant medications were broadly similar between the tocilizumab (n?=?49) and the control (n?=?47) groups. In the IPTW analysis, treatment with tocilizumab was associated with a reduced need for overall ventilatory support (49 vs. 89%, wHR: 0.39 [0.25-0.56]; p?

SUBMITTER: Roumier M 

PROVIDER: S-EPMC7666405 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature